scoliosis
TRANSCRIPT
PREPARED BYDR. MAJID AL-HOMIEDAN
Chapman Explained
Chapman Explained Dr. Majid Al-Homiedan
Scoliosis
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Infantile idiopathic scoliosis
diagnosed before the age of 4 years.
90% are thoracic and concave to the right.
More common in boys.
90% resolve spontaneously.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Juvenile idiopathic scoliosis
diagnosed between 4 and 10 years.
More common in girls.
Almost always progressive.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Adolescent idiopathic scoliosis
diagnosed between 10 years and maturity.
More common in females.
Majority are concave to the left in the thoracic region.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Failure of formation and Scoliosis
Incarcerated hemivertebra. A straight spine with little tendency to progression.
B. Free hemivertebra. May be progressive.
C. Wedge vertebra. Better prognosis than a free hemivertebra.
D. Multiple hemivertebrae. Failure of formation on the same side results in a severe curve.
. E. Central defect. Butterfly vertebra
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Failure of Segmentation and Scoliosis
A. Bilateral block vertebra and a short spine, e.g. Klippel-Feil.
B. Unilateral unsegmented bar. Severely progressive curve with varying degrees of kyphosis or lordosis depending on the position of the bar
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Mixed defects and Scoliosis
Unilateral unsegmented bar and a hemivertebra. Severely progressive.
Partially segmented incarcerated hemi vertebra.
Bilateral failure of segmentation Incorporating a hemi vertebra
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Myelomeningocele and scoliosis
Linked to neurological impairment.
Growth potential.Other vertebral
anomalies.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Spinal Muscular Dystrophy and Scoliosis
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Friedreich’s Ataxia and scoliosis
About 2/3 of patients with FA develop scoliosis mainly due to muscle weakness.
there’s speculation that frataxin gene deficiency might have direct effects on bone development.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Poliomyelitis and Scoliosis
Viral invasion of motor neurons leading to wallerian degeneration,muscle weakness and eventually scoliosis.
Leg length discrepancy and limping is also another cause of scoliosis.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Cerebral Palsy and Scoliosis
Whether flaccid or spastic cerebral palsy both cause scoliosis.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Muscular Dystrophies and Scoliosis
Duchenne muscular dystrophy, deficient gene that makes dystrophin. leading to muscle break-down and weakness.
Becker muscular dystrophy Myotonic dystrophy. Limb-girdle muscular
dystrophy Facioscapulohumeral
muscular dystrophy
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Neurofibromatosis and Scoliosis
in up to 40% of patients short, sharply angulated
curve which involve only few vertebra associated with:
- Neural foramina enlargement
- Rib penciling- kyphosis- Vertebral body scalloping- Dural ectasia- Soft tissue masses
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
scoliosis in 40-60%. Double structural curves are typical.
Marfan’s syndrome and scoliosis
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Homocystinuria and Scoliosis
Inherited disorder of the metabolism of the amino acid methionine.
Multisystemic disorder of the connective tissue, muscles, CNS, and cardiovascular system.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Scoliosis Post Radiotherapy
Wedged and hypoplastic vertebrae ± unilateral pelvic or rib hypoplasia
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Leg-length discrepancy and Scoliosis
A flexible lumbar curve, convex to the side of the shorter leg
Disparity of iliac crest level.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Osteoid Osteoma and Scoliosis
10% occur in the spine.
A lamina or pedicle at the apex of the curve will be sclerotic or over grown.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Osteoblastoma and Scoliosis
The spine is involved in about 50 percent of cases and it usually arises in the posterior elements.
It typically causes dull pain and may be associated with scoliosis or nerve compression.
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan